Laparoscopic Appendectomy in Children 6 Years of Age and Younger

Abstract

Purpose: The purpose of this study is to determine the features of laparoscopic appendectomy in children 6 years of age and younger, especially in those with perforated appendicitis.

Methods: A retrospective chart review was conducted for all children who underwent laparoscopic appendectomy for acute appendicitis over 2 years and 5 months at our institution. A total of 117 children were registered and divided into two groups: preschool (6 years old and younger, n = 19) and school children (7–15 years old, n = 98). We comparatively reviewed these two groups in terms of age, sex, duration of symptoms, symptoms at presentation, physical findings, white blood cell count, C-reactive protein (CRP) level, usage of computed tomography, presence of fecalith and perforation, operative time, insertion of drain, pathological findings, length of hospital stay, and postoperative complications. The preschool children were further divided into two groups: those with perforated (n = 12) and those without perforated appendicitis (n = 7). The same evaluation was carried out on these groups.

Results: There were statistically significant differences between preschool children and school children in terms of fever (> 37.5°C), CRP level, presence of perforation, operative time, insertion of drain, frequency of gangrenous appendicitis, and length of hospital stay. The operative time and length of hospital stay were significantly longer in preschool children with perforated appendicitis than in those without perforated appendicitis.

Conclusions: The presence of perforation was significantly more frequent in preschool children than in school children, regardless of the duration of symptoms. In preschool children, the presence of perforation affected the operative time and length of hospital stay.